XNEOR - DEVELOPMENT AND EVALUATION OF AN EXPERT-SYSTEM TO IMPROVE THEQUALITY AND COST OF DECISION-MAKING IN NEUROONCOLOGY

The treatment of brain tumors requires a large team of medical experts . However, the process of medical decision-making for these patients i s hampered by the frequent inaccessibility of the experts because of c onflicting scheduling, inconsistencies in the management of different patients, and the fact that multiple experts often yield multiple opin ions. The goals of this work were (1) to develop and validate an exper t system to assist the medical team deliver efficient, quality care to children with recurrent medullo-blastoma, a common type of pediatric brain tumor, and (2) to determine if the expert system can be used as an educational tool. The results of our study indicate that residents enjoy learning by using XNEOr, the brain tumor expert system. XNEOr en abled residents to order appropriate ancillary tests for patients and to make fewer incorrect treatment decisions. The potential net effect of residents using XNEOr may be increased patient and family satisfact ion and decreased probability of medical liability. At a time of impor tant changes in our health care system, novel expert systems hold prom ise as tools to reduce medical costs, improve the quality of multi-exp ert medical care, and advance health care education.